Prevalence and Factors Associated With Bone Erosion in Patients With Gout

Wu, Mian; Liu, Fengjiang; Chen, Jie; Chen, Li; Wei, Chong; Hu, Zhu M.; Han, Ying; Lü, Jun; Jiang, Li; Chen, Hai B.

doi:10.1002/acr.23816

Cited by 27 publications

(19 citation statements)

References 24 publications

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“…ULT may diminish HAG and improve synovitis and synovial hypertrophy. Bone erosion was known to be an irreversible injuriousness in gout [23]. In our study, tophi and DCS were both found to be correlated with bone erosion.…”

Section: Discussionsupporting

confidence: 60%

Performance of Ultrasound in the Clinical Evaluation of Gout and Hyperuricemia

Cao

Zhao

Xie

et al. 2021

Journal of Immunology Research

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Objective. To evaluate monosodium urate (MSU) crystal deposition and related lesions in the joints of patients with gout and hyperuricemia (HUA) using ultrasound. To explore the association between ultrasound findings and clinical features in gout and HUA. Methods. A total of 202 patients with gout and 43 asymptomatic patients with HUA were included. The clinical data and ultrasonic assessment results were collected and statistically analyzed. Results. Deposition of MSU crystals was found in 25.58% (11/43) of patients with asymptomatic HUA and 76.24% (154/202) of patients with gout. Of the 1,082 joints from patients with gout examined, 33.09% (358/1082) displayed MSU crystal deposition. In the joints with MSU crystal deposition, 77.37% (277/358) had a history of attacks. Among the joints of gouty arthritis, double contour sign (DCS), hyperechoic aggregate (HAG), and tophi were found in 32.65% (159/487), 7.80% (38/487), and 24.64% (120/487) of the joints, respectively. DCS and tophi, but not HAG, increasingly appeared with the extension of gout duration. In patients with more than 15 years of gout history, DCS, Tophi, and HAG were found in 48.18%, 40.00%, and 6.36% of US assessed joints, respectively. In patients with gout, synovial lesion and bone erosion were found in 17.74% (192/1082) and 7.58% (82/1082) of joints, respectively. The synovial lesion was related to HAG, while bone erosion was related to tophi and DCS. Nephrolithiasis was detected in 20.30% (41/202) of patients with gout and 4.65% (2/43) of HUA patients, indicating that nephrolithiasis occurred in more patients with gout than in patients with HUA. Conclusion. HAG is an early performance of MSU crystal deposition in joints of gout and HUA. Both DCS and tophi are risk factors for bone erosion. Early urate-lowering therapy (ULT) should be considered in patients with gout, DCS, or tophi.

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Section: Discussionsupporting

confidence: 60%

Performance of Ultrasound in the Clinical Evaluation of Gout and Hyperuricemia

Cao

Zhao

Xie

et al. 2021

Journal of Immunology Research

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show abstract

“…ULT may diminish HAG and ameliorate synovitis or synovial hypertrophy. Bone erosion was known to be an irreversible injuriousness in gout (23). In our study, Tophi and DCS were both found to be correlated with bone erosion.…”

Section: Discussionsupporting

confidence: 60%

Performance of Ultrasound in the Clinical Evaluation of Gout and Hyperuricemia

Cao

Zhao

Xie

et al. 2020

Preprint

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Objective Evaluation of monosodium urate (MSU) crystal deposition and related lesion in joints using ultrasound in gout and hyperuricemia patients. Methods Total 202 gout patients and 43 asymptomatic hyperuricemia patients were included, the clinical data and ultrasounic assessment results were collected and statistically analyzed. Results Deposition of MSU crystals were found in 25.58% (11/43) of the patients with asymptomatic hyperuricemia and 76.24% (154/202) of the patients with gout. In the all examined 1082 joints from gout patients, 33.09% (358/1082) of them were detected MSU crystals. In MSU crystal positive joints, 77.37% (277/358) of them had history of attacks. Among the joints of gouty arthritis, 56.88% (277/487) of them were found MSU crystals. Double contour sign (DCS), hyperechoic aggregate (HAG) and Tophi were found in 32.65% (159/487), 7.80% (38/487) and 24.64% (120/487) of the joints, respectively. DCS and Tophi, but not HAG, appeared inceasingly in gout duration extension. In the patients with more than 15 years of gout history, DCS, Tophi and HAG were found in 48.18%, 40.00%, 6.36% of US assessed joints, respectively. In the gout patients, synovial lesion and bone erosion were found in 17.74% (192/1082) and 7.58% (82/1082) of joints, respectively. Synovial lesion was related with HAG, while bone erosion was related to tophi and DCS. Conclusion HAG is the early sign of MSU crystal deposition in joints. Early urate lowering therapy (ULT) may reduce HAG and ameliorate synovitis and synovial hypertrophy. DCS and tophi are the risk factors of bone erosion. Early ULT should be considered in the gout patients with DCS or tophi.

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“…The biological processes involved in MSU crystal formation are not yet clear; further analysis is needed regarding whether humoral immune changes caused by poor sleep habits stimulate the formation and deposition of MSU crystals. In addition, preferential deposition in tissues with minimal vascularisation (e.g., tendons, ligaments, and cartilage) implies that sleep quality has a profound effect on vascular function (24). Sleep deprivation can impair the function of vascular endothelial cells by inducing sympathetic nervous system activation, systemic in ammation, or oxidative stress; these changes reduce blood supply to tissues, which may increase MSU deposition (25).…”

Section: Discussionmentioning

confidence: 99%

Habitually Late Bedtime is Associated With Elevated Serum Uric Acid and Monosodium Urate Monohydrate Deposition in Patients With Gout: A Case Control Study

Rothenberg¹,

Chen²,

Liu³

et al. 2020

Preprint

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Background: In this study, we observed whether habitually late bedtime affects serum uric acid levels and monosodium urate monohydrate deposition in joints and tendons in patients with gout.Methods: This study included 195 patients with gout, who had been divided into two groups based on their bedtime (early or late) and compared serum uric acid levels between the groups. The study also compared ultrasounds of joints and tendons between groups, including the metatarsal-phalangeal joints, knee joints, and tendons of the lower limbs. A multivariate logistic regression was used to analyse the risk factors of monosodium urate monohydrate deposition.Results: Compared to patients with an early bedtime, those with a late bedtime had higher urate levels and a significantly higher proportion of double contour signs, tophi, and bone erosion in metatarsal-phalangeal joints (p < 0.05). Late-bedtime patients also had higher proportions of synovial hypertrophy and double contour signs in knee joints (p < 0.05), and a higher incidence of tophi in the quadriceps tendon (6.4%), compared to early-bedtime patients (2.5%; p < 0.05). Late bedtime was associated with monosodium urate monohydrate deposition. Conclusions: Patients with gout who had a late bedtime exhibited elevated urate levels, enhanced monosodium urate monohydrate deposition, and greater gout-related joint damage, compared to patients with an early bedtime.

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Prevalence and Factors Associated With Bone Erosion in Patients With Gout

Cited by 27 publications

References 24 publications

Performance of Ultrasound in the Clinical Evaluation of Gout and Hyperuricemia

Performance of Ultrasound in the Clinical Evaluation of Gout and Hyperuricemia

Performance of Ultrasound in the Clinical Evaluation of Gout and Hyperuricemia

Habitually Late Bedtime is Associated With Elevated Serum Uric Acid and Monosodium Urate Monohydrate Deposition in Patients With Gout: A Case Control Study

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